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Nephrostomy Tube Insertion

WHAT YOU SHOULD KNOW:

Nephrostomy Tube Insertion (Aftercare Instructions) Care Guide

  • A percutaneous (per-ku-TA-ne-us) nephrostomy (ne-FROS-to-me) tube is a catheter (plastic tube) that is inserted through your skin into your kidney. The nephrostomy tube is placed to drain urine from your body into a collecting bag outside your body. You may need a percutaneous nephrostomy tube when something is blocking the normal path that your urine takes to leave your body. Urine from your kidneys passes through thin, narrow tubes called ureters. Your ureters are connected to your bladder where urine is stored for a time before you urinate. When your ureters get blocked by stones or blood clots, urine stays in your kidneys and will cause problems. The nephrostomy tube is put in to drain your urine directly from your kidneys. You may need this tube if you have pelvic tumors, damage to the urinary system, prostate cancer, or other conditions.
    Urinary System


  • You may need one nephrostomy tube, or two tubes if you need one for each of your kidneys. To place a percutaneous nephrostomy tube, a tunnel is made from your lower back through and into your kidney. Through this tunnel, the tube is placed and left in to drain urine from your kidney into a drainage bag. A nephrostomy tube can relive symptoms such as pain and fullness, and can help prevent damage to your kidney.

INSTRUCTIONS:

Take your medicine as directed.

Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

  • Pain medicine: You may need medicine to take away or decrease pain.

    • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.

    • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

  • Nephrostography: This is a test that will be done 1 or 2 days after your procedure to check for any problems.

Drinking liquids:

Adults should drink about 9 to 13 cups of liquid each day. One cup is 8 ounces. Good choices of liquids for most people include water, juice, and milk. Coffee, soup, and fruit may be counted in your daily liquid amount. Ask your caregiver how much liquid you should drink each day.

Care of your nephrostomy tube:

Since the nephrostomy tube comes out of a hole made in your back, you will not be able to care for it by yourself. Ask for help caring for your nephrostomy tube. Ask your caregiver how you should clean your skin, and what skin barriers and attachment devices you should use. Ask caregivers what type of urinary drainage bag you should use. If the bag is not single-use, ask when and how it should be cleaned.

Preventing problems with the nephrostomy tube:

  • Keep the tube taped to your skin and connected to a drainage bag. The drainage bag must stay below the level of your kidneys (lower back).

  • Check the catheter to be sure it is in place after changing your clothes or doing other activities. Do not wear tight clothing over the tube. Place the tubing over your thigh rather than under it when you are sitting down. Be sure there is no tension (pulling) on the nephrostomy tube when you move around.

  • Change positions if you see little or no urine in your drainage bag. Check to see if the urine tube is twisted or bent. Be sure that you are not sitting or lying on the tube.

  • If your caregiver has taught you, irrigate (flush) the tube. Do this if you think the tube is blocked. Ask caregivers if you should irrigate the tube and do it only if you have been taught how.

CONTACT A CAREGIVER IF:

  • The skin around where the tube enters your body is very red or swollen.

  • You have a fever.

  • You have lower back or hip pain.

  • You often have bright red drainage coming out of your tube, or you have other changes in how your urine looks or smells.

  • You have large amounts of urine draining into the drainage bag over a short period of time.

  • You have little or no urine draining from the nephrostomy tube.

  • You have an upset stomach and are throwing up.

  • Your skin is itchy, swollen, or has a rash.

SEEK CARE IMMEDIATELY IF:

  • The black mark on your tube (if there is a mark) has moved, or you see that your tube is longer than it was when it was put in.

  • The nephrostomy tube comes out.

  • There is blood, pus, or a bad smell coming from the place where the tube enters your skin.

  • Urine is leaking around the tube 10 days after the tube was placed.

  • Your bandage is suddenly soaked with blood.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of the Blausen Databases or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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